Person Center — Utilization Tab

athenahealth Population Health

The Person Center Utilization tab provides an overview of key information about cost, services used, and severity (retrospective risk score).

 

On the Main Menu, enter the patient's name, patient ID, or member ID (insurance number) in the Search Bar. Under NETWORK PATIENTS, select the data type and then click the search icon. Matching patients are listed under the Patients tab. Click the patient name to expand the selection, and then click the patient name in large text to display the patient's Person Center. Click the Utilization tab on the left side.

 

 

 

Your organization must use athenahealth Population Health, and you must have the View Milliman Data role to access this tab.

 

 

 

The Utilization tab provides year-to-date cost, service, and retrospective severity data for a patient. This information is gleaned from claims data.

  • Cost

    Provides per member per month (PMPM) cost as well as a severity adjusted PMPM.

  • Service Utilized

    Lists the number of events for various event classifications, such as ED visits and office visits.

  • Severity

    For clients who have implemented the Milliman Advanced Risk Adjuster (MARA) logic, this section shows the retrospective severity risk score, as well as what drives this score, for a patient.

Note: If your facility uses Ingenix to calculate severity data, your severity data could appear as 0 on the Utilization tab.

 

 

All utilization data in the Person Center is calculated year to date (YTD). Utilization data is calculated from January 1 to the date your organization last loaded claim files for the year selected in the End Date filter. Headings in the Utilization tab carry the YTD abbreviation to note the method of calculation.

 

 

 

You can filter Person Center severity and utilization data by month as well as by year. The Person Center End Date filter uses a month-year format, to select data that appears in the Utilization tab. The data is calculated year to date, to the month selected in the End Date filter.

 

The application calculates data for other tabs in the Person Center by year, not by month and year. In these cases, figures depend only on the year in the End Date filter.

 

 

 

 

 

In a patient's Person Center, adjust the End Date filter:

  1. Display a patient's Person Center Utilization tab: On the Main Menu, enter the patient's name, patient ID, or member ID (insurance number) in the Search Bar. Under NETWORK PATIENTS, select the data type and then click the search icon. Matching patients are listed under the Patients tab. Click the patient name to expand the selection, and then click the patient name in large text to display the patient's Person Center. Click the Utilization tab on the left side.
  2. Click END DATE near the top of the page.
    The END DATE box appears.
  3. Click << or >> to select the year.
  4. Click the month in the selected year of interest.
  5. Click Apply.

 

 

If you use the MARA logic, you can view your severity score on this tab.

  1. Display a patient's Person Center Utilization tab: On the Main Menu, enter the patient's name, patient ID, or member ID (insurance number) in the Search Bar. Under NETWORK PATIENTS, select the data type and then click the search icon. Matching patients are listed under the Patients tab. Click the patient name to expand the selection, and then click the patient name in large text to display the patient's Person Center. Click the Utilization tab on the left side.
  2. Scroll to the Severity section of the Utilization tab to view retrospective MARA severity scores.

 

 

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